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60 Cards in this Set
- Front
- Back
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Atrial Fibrillation Trials |
AFFIRM ARISTOTLE RELY SPAF I-III |
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Pacemaker Trials |
AVID MADIT REVERSE SCDHeFT |
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Lipid Trials |
AtoZ JUPITER LIPID PRINCESS/MIRACL TNT WOSCOPS |
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Preventive Cardiology Trials |
ALLHAT Framingham HOPE SHIFT UKPDS WHI |
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Heart Failure Trials |
AIRE CAPRICORN CHARM CIBIS COPERNICUS EPHESUS MERIT-HF RALES RESOLVD SAVE, TRACE, SOLVD VALIANT V-HEFT |
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Coronary Artery Disease Trials |
ACUITY CAPRIE CAST COMMITT CURE GISSI-3 GUSTO-1 HORIZONS-AMI ISIS-2 Norwegian Timolol PLATO TACTICS-TIMI 18 TRITON-TIMI 38 |
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Interventional Cards Trials |
CARP ERACI, GABI, BARI, CABRI, RITA, EAST FRISC-II, RITA-3 GUSTO-2B NORDISTEMI Partner Trials SHOCK SYNTAX |
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AFFIRM |
No difference in mortality between rate and rhythm control, however, increased mortality in rhythm control in older pts, those with CAD, those without CHF
2002 |
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ARISTOTLE |
Apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality.
2011 |
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RELY |
Dabigatran is non‐inferior to warfarin in preventing stroke and systemic embolism with lower major bleeding profile; slight increase in GI bleeding
2009 |
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SPAF I, SPAF II, SPAF III |
Warfarin > ASA > placebo in reducing stroke events in AFib. For high risk patients with Afib, Warfarin INR 2‐3 is more effective. Low risk patients, ASA 325 has acceptable low risk of stroke < 3%. Sub‐study of SPAF III established high risk factors of the CHADS2 risk score;
1991, 1994, 1996 |
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AVID |
ICD is more effective than antiarrythmic drugs in reducing arrhythmia related cardiac deaths.
1999 |
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MADIT |
Defibrillator along with BiV ICD (CRT‐ICD therapy) is associated with improved EF and HF. Most benefit in reducing HF events in pts with QRS > 150, EF<30%
2009 |
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REVERSE |
CRT reverses remodeling in systolic LV dysfunction, pts with asymptomatic to mild HF or wide QRS, EF < 40 ‐ significant improvement in reverse LV remodeling seen by measures of LVESV and LVEDV along with EF after 6 months in pts with CRT with further improvement overtime; there was significant decrease in morbidity and mortality
2009 |
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SCDHeFT |
Amio vs. placebo, ICD vs. placebo for CHF ‐ In pts with mild‐ moderate CHF, EF <35, shock only ICD reduced risk of death (ARR 7.2% at 5 years), main effects in pts with Class II symptoms, minimal effect in Class III; Amio showed no benefit in Class II, but reduced survival in Class III
2005 |
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AtoZ |
NSTEMI, STEMI Reduction in CV death, MI and readmission for ACS reduced in pt receiving zocor. Significant decrease in CV death and CHF
2004 |
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JUPITER |
Rosouvastatin reduced primary endpoint (CV death, MI, CVA, unstable angina, revascularization) in women > 60 and men > 50, LDL < 130 – low normal, elevated hsCRP > 2 by 44%
2009 |
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LIPID |
Pravastatin reduced mortality from all causes and CV events in pts with ACS and cholesterol 155‐ 271
1998 |
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PRINCESS/MIRACL |
Early <96hr initiation of atorvastatin improved MI and revasc in AMI patients
MIRACL 2001 |
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TNT |
Pts with CAD (prior MI +/‐ revascularization, stable angina) ‐ Lipitor ‐ high dose has significantly lower LDL and total cholesterol levels, and reduced risk of major CV event
2005 |
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WOSCOPS |
Pts hyperlipidemia and no hx of MI, pravastatin reduced CV deaths (RRR 30%) and need for revascularization (RRR 37%)
1995 |
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ALLHAT |
Thiazide vs. CCB vs. ACEI ‐ Thiazide type diuretics (chlorthalidone) are superior at preventing 1 or more forms of CVD and should be first line of therapy; amlodipine higher 6 yr rate of HF and lisinopril had higher 6 yr rates of CHD, stroke, and HF
2002 |
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Framingham |
High levels of LDL, Hypertension, cigarette smoking, obesity, elevated blood sugar levels, stress, lack of exercise, menopause, ECG abnormalities increase risk of coronary heart disease
1984 |
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HOPE |
Ramipril reduced risk of death, MI, stroke, and revascularization. Vitamin E did not lower the risk of CAD
2000 |
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SHIFT |
Ivabradine reduction in hospitalization or CV death from heart failure.
2010 |
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UKPDS |
(HTN in Diabetes study) ‐ BP control < 150/85 in pts with HTN and Diabetes with ACEI or BB, plus additional meds if needed, reduces risk of diabetic related complications and death related to diabetes (MI, PV0D, renal disease, CVA, sudden death) along with decrease in progression of neuropathy and retinopathy
1998 |
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WHI |
(Women’s Health Initiative) ‐ post menopausal women on combined hormonal therapy is associated with increased risk of CAD, PE, CVA and invasive breast cancer but decreased risk of hip fractures and colorectal cancer; absolute risk excess was 19 per 100,000 person‐years
2002 |
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AIRE |
Ramipril started 3–10 days after MI, benefit noticeable as early as 30 days, reduction in progression to heart failure; no reduction in reinfarction or stroke
1993 |
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CAPRICORN |
Carvedilol decreases cardiovascular and all cause mortality in post‐ infarction pts with EF < 40%
2001 |
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CHARM |
Candesartan addition to concurrent BB and/or ACEI therapy –significant reduction in CV death or hospital admission for CHF (16%); NNT is 23 in 1 year
2003 |
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CIBIS |
EF < 35% and NYHA class III or IV, B1 blocker bisoprolol significantly reduced all cause mortality, sudden death, and all cause hospitalizations from CHF
1999 |
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COPERNICUS |
Coreg in addition to diuretic plus ACE/ARB reduces all cause mortality and hospitalization
2001 |
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EPHESUS |
Eplerenone in addition to standard therapy reduces mortality in pts with severe CHF
2001 |
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MERIT-HF |
Toprol CR/XL when used on top of ACE‐I reversed ventricular remodeling as shown by decreased LV‐ EDV and ESV by cardiac MRI and decreases all cause mortality when started in pts with CHF
2000 |
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RALES |
Aldactone 25 mg in addition to standard therapy reduces mortality and risk of sudden death in pts with severe CHF (EF < 35, Class 3‐4); RRR 30%
1999 |
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RESOLVD |
Enalapril plus candesartan combination was more beneficial in preventing LV dysfunction (reduced ESV and EDV), compared to either drug alone
1999 |
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SAVE, TRACE, SOLVD |
ACEI reduces all cause mortality remodeling, and decreased risk of worsening heart failure when started 2-10 days after MI, and in pts with CHF (EF <35%)
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VALIANT |
ARBs have mortality equivalent to ACEI, side note
1999 |
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V-HEFT |
Vasodilator (enalapril vs. hydralazine/nitrate)‐Heart Failure Trial) ‐ pts with CHF on digoxin and diuretic; enalapril has greater reduction mortality
1991 |
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ACUITY |
Enoxaparin equivalent to heparin upstream during ACS
2004 |
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CAPRIE |
Plavix was slightly better than aspirin in reducing primary endpoints of MI, CVA, and vascular death; conferred benefit for CVA and PAD; no benefit in pts with previous MI
1996 |
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CAST |
Flecanide and encanide increased mortality in pts with post‐MI asymptomatic or mildly symptomatic supraventricular arrhythmias
1989 |
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COMMITT |
Plavix plus ASA reduces 30 day mortality (0.6% ARR), BB good after MI if pts do not have heart failure/cardiogenic shock
2005 |
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CURE |
Plavix in addition to aspirin in patients with non‐STEMI ACS reduces risk of CV death, MI, and CVAs by 20%
2002 |
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GISSI-3 |
Lisinopril, when given < 24 hrs in pts with acute MI, reduced mortality and severe LV diastolic dysfunction (EF <35%)
1994 |
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GUSTO-1 |
Accelerated t‐PA plus IV Heparin has lower mortality although higher bleeding than streptokinase and standard therapy
1995 |
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HORIZONS-AMI |
Bivalirudin reduced bleeding and death compared to Heparin plus Glycoprotein IIb/IIIa inhibitor in 30 days; increased <24 hr in stent thrombosis with bivalirudin but offsetted between 24 hrs to 30 days
2009 |
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ISIS-2 |
ASA lowers CV death, Recurrent MI, CVA when given to patients with acute MI
1988 |
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Norwegian Timolol |
In pts who survive acute MI, Beta blockers reduce all cause mortality, sudden death, and reinfarction
1981 |
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PLATO |
Pts with ACS, with or without ST elevation, ticagrelor reduces death from vascular, MI, and CVAs; slight increase non‐procedural related, i.e. fatal intracranial bleeding
2009 |
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TACTICS-TIMI 18 |
GpIIb/IIIa inhibitor plus invasive strategy in pts with moderate‐high risk UA/NSTEMI is better than conservative management
2001 |
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TRITON-TIMI 38 |
Prasugrel reduced CV death, nonfatal MI, nonfatal stroke compared to clopidogrel 19% reduction in CV death, MI or stroke compared with clopidogrel in patients undergoing PCI for ACS
2007 |
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CARP |
In patients with stable CAD, coronary artery revascularization prior to elective major vascular surgery, s.a. expanding AAA, PVOD of legs, does not improve outcomes
2004 |
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ERACI, GABI, BARI, CABRI, RITA, EAST |
PTCA and CABG have similar rates of survival and avoidance of MI and similar long term health care costs; PTCA group had increased rates of recurrent angina and revascularization; nearly 1⁄4 of PTCA patients required CABG; At 10 year follow up some studies showed that Diabetics and pts > 65 yrs have slightly decreased mortality with CABG; Subset of CABRI trial ‐ pts with multi‐vessel or chronically occluded major vessel disease had better outcomes with CABG;
1994, 1994, 1996, 1995, 1998, 1999 |
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FRISC-II, RITA-3 |
At 5 year follow up, in moderate‐ high risk pts with ACS without ST elevation, early invasive intervention strategy has improved outcomes in terms of death/MI
2005, 2006 |
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GUSTO-2B |
PTCA has better outcomes than thrombolysis in pts with AMI. lowest 30 day mortality when D2B time < 60 minutes (1%), 60–90 minutes (4%), > 90 minutes (6.5%)
1997 |
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NORDISTEMI |
Early invasive strategy in pts with STEMI has significant reductions in primary outcomes (death, stroke, reinfarction) at 30 days, but at 12 months, reductions were nonsignificant, but trended towards significance as invasive group had less incidence of death, strokes, reinfarction at 12 months
2010 |
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Partner Trials |
TAVR superior to medical therapy and equivalent to surgical therapy of high risk patients
2011 |
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SHOCK |
In pts with cardiogenic shock due to acute MI, early revascularization vs. medical stabilization does not improve 30 day mortality but does improve 6‐ month and 12 month survival
1995 |
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SYNTAX |
PCI vs. CABG in pts with severe CAD ‐ At 1 yr, CABG group had lower rates of major cardiac or cerebrovascular events (12% vs. 18%) and repeat revascularization (6% vs. 14%); however, there was increase in rate of strokes (2.2% vs. 0.6%). Conclusion ‐ CABG should be standard of care in pts with severe 3 vessel or left main disease;
2009 |
